Monitoring electrical signals in newborns with electrodes

Albert Fabregat

Universitat Rovira i Virgili (URV), Spain

Birth and the first hours of a newborn's life are considered a period of risk. A premature birth, a reduction in blood flow during birth or an infection can cause brain damage to the newborn that can result in varying degrees of disability. That is why early detection is essential, so that the appropriate therapies can be applied with the aim of minimising any harmful effects.

The technique most frequently used to study brain function in newborns placed in neonatal intensive care units (NICUs) is amplitude-integrated electroencephalography (aEEG), which consists of amplifying and recording the electrical activity of neurons in the brain. aEEG is used to detect the onset of brain damage, such as hypoxic encephalopathy or epilepsy. However, the recording devices used to capture the brain's electrical signal, electrodes, are not specifically designed for newborns. Electrodes for adults are often used, but these are not so suitable for newborns’ small, sensitive heads. Moreover, recordings often take place over prolonged periods – from days to weeks – as it is necessary to monitor the newborn’s brain function throughout their time in the NICU, and the electrodes do not adhere properly to such a small head. This lack of adherence leads to the appearance of artifacts in the aEEG recording that may hinder or prevent the correct interpretation of the signal obtained by the neonatologist, and this can result in inaccurate or even erroneous treatment of the newborn.

The researchers in this project have designed a new electrode specifically for newborns (aCUP-E), with the capacity to replace the electroconductive gel for prolonged recordings. The electrode is adapted to the cephalic characteristics of newborns, and is flexible and transparent, enabling better recording of brain activity, enabling early diagnosis of lesions and making it easier to monitor newborns. The electrode is already being tested in a clinical trial. The researchers have also developed an advanced system that enables these electrodes to be positioned at specific anatomical points, individualised for each patient. The system, known as EPlacement, eliminates the potential errors that can occur during the positioning of electrodes on the head in clinical practice.

This new cranial point positioning system can be applied in both paediatric and adult patients and could also be useful for other diagnostic tests or electrophysiological treatments that require specific electrode positioning on the cranial surface, such as intraoperative neurophysiological monitoring or non-invasive brain stimulation.

• Vicenç Pascual Rubio, Institut d’Investigació Sanitària Pere Virgili (IISPV), Spain